Mental Health Nursing: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

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1Formulas and methods

Mental health nursing

Method

  1. Decide whether there is an immediate risk: suicide, violence, a drug emergency or a physical illness.
  2. Act on safety first: observe, remove means, de-escalate, stop a harmful drug, get help.
  3. Choose the therapeutic response: acknowledge feelings, present reality, avoid false reassurance and “why” questions.
  4. Respect rights: the least restrictive option, consent and confidentiality with its limits.

2Practice problems

1.Mental health nursingMedium

Which US legal case is associated with the duty of mental health professionals to protect people who are threatened by a patient?

  1. ATarasoff v Regents of the University of California
  2. BBrown v Board of Education
  3. CRoe v Wade
  4. DMiranda v Arizona
2.Mental health nursingHard

During a session, a patient says he intends to seriously harm a named neighbour. What is the correct general principle?

  1. AThe nurse should personally go and warn the neighbour without telling the team
  2. BThe threat should be ignored because patients often say things they don't mean
  3. CConfidentiality means nothing can be shared
  4. DThe risk to an identifiable person must be shared with the team and may need to be disclosed to protect that person, following the law and policy
3.Clinical psychologyMedium

In suicide risk assessment, which factor is one of the strongest predictors of a future suicide attempt?

  1. ABeing a university student
  2. BA previous suicide attempt
  3. CTalking openly to a therapist
  4. DHaving a large circle of friends
4.Clinical psychologyHard

Which evidence best supports CBT as a treatment for anxiety disorders, rather than a placebo effect?

  1. ACBT has been used for over fifty years
  2. BClients say they like their therapists
  3. CRandomised trials show CBT outperforms credible attention-placebo control conditions
  4. DCBT is cheaper than medication
5.PharmacologyMedium

When does oseltamivir give the most benefit in influenza?

  1. AOnly after a bacterial pneumonia has developed
  2. BOnly after symptoms have lasted at least one week
  3. CAt any time, as the timing makes no difference
  4. DWhen started within 48 hours of the first symptoms
6.PharmacologyHard

A nurse gives 2 mg from a 4 mg ampoule of morphine. What should happen to the remaining 2 mg?

  1. AIt is discarded in front of a witness, and both sign the record
  2. BIt is poured down the sink without telling anyone
  3. CIt is given to the next patient who needs morphine
  4. DIt is kept labelled in the patient's drawer for the next dose

3Solutions

1.Mental health nursing

Answer: A · Tarasoff v Regents of the University of California

Why this is the answer

In Tarasoff (California, 1976), the court held that therapists have a duty to take reasonable steps to protect an identifiable person from a serious threat made by a patient. Similar principles exist in many jurisdictions.

Answer

A · Tarasoff v Regents of the University of California
2.Mental health nursing

Answer: D · The risk to an identifiable person must be shared with the team and may need to be disclosed to protect that person, following the law and policy

Why this is the answer

A serious threat against an identifiable person overrides confidentiality. The nurse informs the team, documents the threat and follows the legal and policy procedures for protecting the person.

Answer

D · The risk to an identifiable person must be shared with the team and may need to be disclosed to protect that person, following the law and policy
3.Clinical psychology

Answer: B · A previous suicide attempt

Why this is the answer

A history of suicide attempts is among the strongest risk factors. Asking directly about suicidal thoughts does not increase risk and is part of good assessment.

Answer

B · A previous suicide attempt
4.Clinical psychology

Answer: C · Randomised trials show CBT outperforms credible attention-placebo control conditions

Why this is the answer

Showing superiority over a credible placebo control rules out non-specific factors as the only explanation. Many trials and meta-analyses report this for CBT in anxiety disorders.

Answer

C · Randomised trials show CBT outperforms credible attention-placebo control conditions
5.Pharmacology

Answer: D · When started within 48 hours of the first symptoms

Why this is the answer

Neuraminidase inhibitors work best early, while the virus is multiplying. Started within 48 hours, they shorten illness; in high-risk or hospitalised patients they may still be given later.

Answer

D · When started within 48 hours of the first symptoms
6.Pharmacology

Answer: A · It is discarded in front of a witness, and both sign the record

Why this is the answer

Unused controlled drugs are wasted in front of a witness according to policy, and both staff document the waste. This prevents diversion and keeps the stock count accurate.

Answer

A · It is discarded in front of a witness, and both sign the record

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